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Extracorporeal Lithotripsy Endoscopically Controlled By Ureterorenoscopy (LECURS): A New Concept For The Treatment Of Kidney Stones—first Clinical Experience Using Digital Ureterorenoscopes

Olivier Traxer, Julien Letendre
Published 2013 · Medicine
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PurposeTo evaluate the feasibility and usefulness of extracorporeal lithotripsy endoscopically controlled by simultaneous flexible ureterorenoscopy (LECURS) and combined with Holmium laser lithotripsy for kidney stones surgery.MethodsRetrograde flexible ureteroscopy allowed stone visualization and intrarenal relocation when possible. Extracorporeal schock wave lithotripsy (ESWL) was performed under direct vision allowing constant focal zone adjustment for optimal stone fragmentation. Holmium laser lithotripsy was used simultaneously when necessary. Post-operative assessment included ultrasound at day one and abdominal CT scan 3 weeks later to evaluate for residual fragments.ResultsSix patients with kidney stones were recruited including 3 with relative contraindication to ESWL. One patient had a stone beyond an infundibular stenosis and 2 had multiple stones in a horseshoe kidney with an uretero-pelvic junction (UPJ) stricture. A 100 % stone fragmentation rate was obtained. Post-operative ultrasound was normal in 5 patients and showed slight peri-renal infiltration in the other. One patient developed an obstructive pyelonephritis requiring antibiotics and changing a double J to a ureteral catheter. No other complications were noted. Three patients (50 %) were stone free after LECURS. Three patients underwent a second-look procedure for small (<3 mm) retained residual fragments. No damage was seen with the digital ureteroscopes, laser fibers or stone baskets.ConclusionsThis initial experience with LECURS has shown to be feasible and safe. This opens the opportunity for further evaluation of this approach in order to improve outcomes of both approaches.
This paper references
10.1089/0892779041271625
Does failure to visualize the ureter distal to an impacted calculus constitute an impediment to successful lithotripsy?
Mukul Sinha (2004)
10.1089/end.2005.19.464
Combined ureterorenoscopy and shockwave lithotripsy for large renal stone burden: an alternative to percutaneous nephrolithotomy?
Jason M. Hafron (2005)
10.1016/j.eururo.2011.04.031
Modified supine percutaneous nephrolithotomy for large kidney and ureteral stones: technique and results.
András Hoznek (2012)
10.1089/end.2012.0217
Flexible ureteroscopy and laser lithotripsy for stones >2 cm: a systematic review and meta-analysis.
Omar M. Aboumarzouk (2012)
10.1111/j.1464-410X.2012.11352.x
Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi.
Jacob Howard Cohen (2013)
10.1089/end.1997.11.33
Expanding the horizons of SWL through adjunctive use of retrograde intrarenal surgery: new techniques and indications.
Anup N. Patel (1997)
10.1002/14651858.CD007044.pub2
Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones.
Attasit Srisubat (2009)
10.1111/J.1464-410X.2007.07117.X
Outcomes using a fourth-generation lithotripter: a new benchmark for comparison?
Michael Nomikos (2007)
10.1089/end.2010.0242
Third prize: the impact of fluid environment manipulation on shockwave lithotripsy artificial calculi fragmentation rates.
Carlos Méndez-Probst (2011)
EAU Guidel edition presented at the 27th EAU Annual Congress, Paris, pp
C Türk (2014)
10.1159/000049803
Guidelines on Urolithiasis1
H G Tiselius (2001)
the effect of different access sheaths, working channel instruments, and hydrostatic pressure
YH Ng (2014)
10.1002/14651858.CD007044.pub3
Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones.
Attasit Srisubat (2014)
10.1089/end.2010.0188
Irrigant flow and intrarenal pressure during flexible ureteroscopy: the effect of different access sheaths, working channel instruments, and hydrostatic pressure.
Yeung H Ng (2010)



This paper is referenced by
10.1016/J.ACURO.2016.08.002
La combinación de litotricia extracorpórea y ureterorrenoscopia flexible optimiza el tratamiento de litiasis renales
A. Perez-lanzac (2017)
10.1111/iju.13957
The Urological Association of Asia clinical guideline for urinary stone disease.
Kazumi Taguchi (2019)
Gr upSM Retrograde Intrarenal Surgery for Renal Stones
Ozcan Kiliç (2016)
10.23736/S0393-2249.18.03084-9
Emergency extracorporeal shockwave lithotripsy as opposed to delayed shockwave lithotripsy for the treatment of acute renal colic due to obstructive ureteral stone: a prospective randomized trial.
Stefano Bucci (2018)
10.5152/tud.2017.22697
Retrograde intrarenal surgery for renal stones - Part 2.
Özcan Kılıç (2017)
10.1007/s00240-017-1015-9
Invited review: the tale of ECIRS (Endoscopic Combined IntraRenal Surgery) in the Galdakao-modified supine Valdivia position
Cesare Marco Scoffone (2017)
10.1016/j.juro.2015.10.059
The Era of Shock Wave Lithotripsy is Over: Yes.
Silvia Proietti (2016)
10.1016/J.ACUROE.2017.02.009
Combination of extracorporeal lithotripsy and flexible ureterorenoscopy optimize renal lithiasis therapy.
A. Perez-lanzac (2017)
10.4111/kju.2015.56.10.680
Current status of flexible ureteroscopy in urology
Sung Yong Cho (2015)
10.5124/JKMA.2016.59.6.459
Current status of minimally invasive surgery for treatment of renal stones and tumors using a flexible ureteroscopy
Sung Yong Cho (2016)
Recent advances in the diagnosis, management and treatment of the most common urological disorders
Mikolaj Przydacz (2016)
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